短暂性脑缺血发作后短期内发生脑梗死的风险分析

目的通过观察并分析短暂性脑缺血发作(TIA)患者临床表现,探讨患者在2d和7d内进展为脑梗死的风险因素。方法对176例2012年1月~2014年1月入院治疗TIA的患者进行回顾性分析,根据TIA患者脑梗死发病率评分系统ABCD2对TIA患者2d和7d内进展为脑梗死的风险因素进行评分,统计学分析风险因素与TIA后短期内发生脑梗死的相关性。结果 TIA患者年龄≥60岁(P0.05)、有高血压史(P0.05)、TIA发作次数≥3次(P0.05)、TIA症状持续时间≥10min(P0.05)、DWI异常(P0.05)和颅内动脉病变(P0.05)与短期内发生脑梗死显著相关;其中抗血小板(P0.05)和抗凝治疗(P0.05)是TIA短期发生脑梗死的保护因素。ABCD2评分越高,TIA后2d和7d内(r=0.957,r=0.975,P0.05)脑梗死发生率越高。结论年龄、高血压史、发作次数、TIA持续时间等是TIA后2d和7d内发生脑梗死的危险因素,适当的抗血小板和抗凝治疗可减少脑梗死发生率。     

联合应用LDL-C和ABCD2评分预测短暂性脑缺血发作患者短期脑卒中风险

目的探讨LDL-C+ABCD2评分法对短暂性脑缺血发作后7 d内发生脑梗死的预测价值。方法用ABCD2评分法和LDL-C+ABCD2评分法分别测定106例TIA患者的评分,并观察TIA后7d内脑梗死的发生率。结果LDL-C+ABCD2评分法和ABCD2评分法的曲线下面积(95%CI)分别为0.849(0.771-0.927)和0.844(0.768-0.920)。采用LDL-C+ABCD2评分中TIA患者中低、中和高危组TIA后7 d内发生脑梗死的比例分别为2.1%、33.3%和64.3%,不同脑卒中风险分层的脑梗死发生率有显著差异(P<0.05)。结论ABCD2评分法是目前临床预测TIA短期进展为脑梗死的有效的方法 ,结合LDL-C检查结果能提高预测的准确性。     

不同性别不稳定型心绞痛患者发病危险因素差异分析

目的:探讨不同性别不稳定型心绞痛(UAP)患者同型半胱氨酸(Hcy)、尿酸(UA)及脑钠肽(BNP)的差异及其与UAP发病的相关性。方法:选取某院心血管内科住院治疗的UAP患者126例作为观察组,另选取同期冠状动脉造影检查正常的非冠心病(CHD)患者68例作为对照组,比较2组受试者一般资料和Hcy、UA及BNP水平差异,采用Logistic回归分析影响不同性别UAP患者发病的因素。结果:高血压病史、LDL-C、Hcy、UA水平在男性观察组与男性对照组间比较,差异有统计学意义(P<0.05);女性观察组与女性对照组间FPG、LDL-C、Hcy及N末端B型利钠肽(NT-proBNP)水平比较,差异有统计学意义(P<0.05)。观察组男性Hcy、UA水平高于女性,而NT-proBNP低于女性,差异有统计学意义(P<0.05)。Logistic回归分析结果显示：高血压病史和Hcy、UA、LDL-C高水平为男性UAP患者发病的独立危险因素;而NT-proBNP、Hcy、FGP、LDL-C高水平为女性UAP患者发病的独立危险因素。结论:不同性别人群影响UAP发生的因素不同,高血压...     

轻中度高同型半胱氨酸血症与冠心病的关系探讨

目的 研究血浆同型半胱氨酸(Hcy)与冠心病之间的相关性,初步探讨Hcy导致冠心病的机制.方法 2012年9月1日至12月30日356例冠心病患者中急性冠状动脉综合征(ACS)组279例,稳定型心绞痛(SAP)组77例,同期冠状动脉造影阴性者159例作为对照组.记录入选对象的性别、年龄、吸烟史、高血压病史、糖尿病史、高胆固醇血症病史、脑血管病史、BMI、TC、LDL-C、HDL-C水平、血浆Hcy、纤维蛋白原(Fib)及高敏C反应蛋白(hs-CRP)水平,组间比较传统心血管病危险因素的差异及血浆Hcy、hs-CRP及Fib的差异;采用Logistic回归模型进行分析,确定Hcy是否是冠心病的独立危险因素.结果 3组在年龄、高血压病史、高胆固醇血症病史、TC、LDL-C方面差异无统计学意义(P＞0.05),但3组在性别、吸烟史、糖尿病史、脑血管病史、HDL-C方面差异有统计学意义(P＜0.05);ACS组血浆Hcy、hs-CRP及Fib水平高于SAP组及对照组[Hcy:(21±6)μmol/L比(16 ±5)、(14±5)μmol/L; hs-CRP:(4.5 ±2.1)mg/L比(2.8±1.9)、(2.1±1.9) mg/L;Fib:(4.1±0.9) g/L比(2.6±0.7)、(2.7±0.8)g/L],差异均有统计学意义(均P＜0.05);SAP组与对照组比较,血浆Hcy水平差异有统计学意义(P＜0.05),hs-CRP及Fib水平差异无统计学意义(P＞0.05);以＞ 15 μmol/L定义高Hcy血症,ACS组高Hcy血症患者多于对照组及SAP组,差异有统计学意义(P＜0.05),而SAP组及对照组比较则差异无统计学意义(P＞0.05);多元Logistic回归分析显示,无论血浆Hcy水平或高Hcy血症作为自变量,均为冠心病的独立危险因素,相对危险度分别为1.087[比值比(OR)=1.087,95％置信区间(CI) 1.045～1.131,P＜0.01]和2.582(OR=2.582,95％ CIl.643 ～4.056,P＜0.01).结论 Hcy是冠心病的独立危险因素,ACS患者血浆Hcy水平高于SAP患者,提示Hcy可能通过参与炎症与血栓机制导致冠心病的发生发展.     

长期干预颈内动脉系统短暂性脑缺血发作患者HHCY的观察

目的探讨长期干预高同型半胱氨酸血症(Hhcy)与颈内动脉系统短暂性脑缺血发作(TIA)预后与转归的相关性,为TIA的治疗与预防提供参考。方法收集伴有Hhcy的颈内动脉系统TIA患者,随机分为治疗组105例和对照组78例,对照组给予常规治疗;治疗组在常规治疗基础上加用叶酸片及维生素B6、维生素B12片(甲钴胺),随访2年后缺血性脑血管事件发生情况;比较治疗前后Hcy水平,评价TIA患者的再发性脑血管事件发生率及药物不良反应发生率。结果 2年后对照组空腹Hcy水平与常规治疗前相比无显著差异,治疗组空腹血浆Hcy水平降低,与治疗前比较有显著差异,治疗组的缺血性脑血管事件复发率与对照组相比无显著差异。结论口服叶酸加维生素B6、B12可降低高同型半胱氨酸血症,且干预Hhcy有减少TIA后再发缺血性脑血管事件的趋势。     

短暂性脑缺血发作患者短期发生脑梗死的危险因素

目的观察分析短暂性脑缺血发作(TIA)患者7d和30d内进展为脑梗死的危险因素。方法以79例TIA为观察对象,收集其临床资料,并按Johnston提出的7分"ABCD2"评分法给予评分,随方TIA患者7d和30d内脑梗死的发生率。结果 TIA发生后29例(36.7%)患者于30d内发生脑梗死,其中18例(22.8%)发生于7d内。"ABCD2"评分≥4分是TIA后发生脑梗死独立危险因素。结论 "ABCD2"评分多的TIA患者短期内脑梗死的发生危险性较高,抗凝治疗可使TIA患者降低脑梗死发生风险。     

短暂性脑缺血发作与后继脑梗死相关危险因素分析

目的观察分析短暂性脑缺血发作（TIA）短期内进展为脑梗死的相关危险因素。方法对60例TIA患者的临床资料进行分析,并按＂ABCD2＂方法给予评分,观察患者短期内（30d内）脑梗死的发生率。结果 19例患者在30d内发生了脑梗死,发生率为31.67%。结论 ＂ABCD2＂评分多的TIA患者短期内进展为脑梗死的概率较大,但积极地抗血栓治疗能降低发生脑梗死的危险。     

高同型半胱氨酸血症与急性脑梗死相关性分析

目的:探讨急性脑梗死与高同型半胱氨酸(Hcy)血症的关系。方法:选取150例合并高血压的急性脑梗死住院患者为观察组,另选取同期门诊就诊的未发生脑梗死的高血压患者150例为对照组。两组患者分别进行空腹Hcy水平的测定,并进行比较。根据入院24 h内Hcy是否升高,将150例脑梗死住院患者分为高Hcy组(88例)和正常Hcy组(62例),两组患者分别于住院时及发病4周时进行神经功能缺损评分(NIHSS评分)。结果:高同型半胱氨酸血症在观察组中占58.7%,对照组中占15.3%(P<0.01);空腹Hcy浓度观察组为(31.26±4.61)μmol/L,对照组为(15.92±3.43)μmol/L,差异有统计学意义(P<0.01)。高Hcy组与正常Hcy组入院时NIHSS评分比较,差异无统计学意义(P>0.05)。两组于发病4周时进行NIHSS评分,高Hcy组评分高于正常Hcy组(P<0.01)。结论:高Hcy血症是脑梗死发生的重要危险因素,高Hcy的脑梗死患者预后较差。积极干预高Hcy血症有助于防止脑梗死的发生或改善脑梗死患者的预后。     

绝经后2型糖尿病患者血浆同型半胱氨酸水平与脆性骨折关系探讨

目的 探讨绝经后2型糖尿病患者血浆同型半胱氨酸(Hcy)水平与骨代谢指标、骨密度(BMD)、脆性骨折的关联性。方法 将110例绝经后2型糖尿病患者按Hcy检查结果分为两组，高Hcy组(Hcy≥10μmol/L)及正常Hcy组(Hcy<10μmol/L)。高Hcy组75例，正常Hcy组35例。比较两组的一般资料及I型原胶原氨基端延长肽(PINP),β胶原特殊序列(β-CTX),腰椎、髋部骨密度及脆性骨折发生情况。结果 高Hcy组患者的年龄、BMI、血钙、血磷、腰椎骨密度、髋部骨密度、PINP、25-OHD与正常Hcy组患者组间比较差异均无统计学意义(P>0.05),高Hcy组的β-CTX与正常Hcy组比较，差异有统计学意义(P<0.05);高Hcy组患者脆性骨折发生率高于正常Hcy组(P<0.05)。结论 血浆同型半胱氨酸水平与绝经后2型糖尿病患者骨质疏松及脆性骨折发生存在一定关联，高同型半胱氨酸血症可能是骨质疏松及脆性骨折发病过程中的一个危险因素。     

短暂性脑缺血患者低密度脂蛋白和同型半胱氨酸水平分析及护理对策

目的探讨低密度脂蛋白和同型半胱氨酸对短暂性脑缺血（transient ischemic attack,TIA）患者的影响,针对危险因素,提供有效的、可操作的护理措施及健康教育,从而有效减少TIA的不良预后。方法选取2012年1月至2014年1月间在广州医科大学附属第一医院神经内科门诊和住院部首诊为TIA患者125例,首诊为脑梗塞患者68例,详细记录入选患者基数资料及实验室检查结果,分析TIA和脑梗塞患者低密度脂蛋白（low density lipoprotein,LDL）和同型半胱氨酸（homocysteine,Hcy）水平。结果TIA组患者在吸烟、饮酒、NIHSS评分、MRS评分与脑梗塞组比较差异有统计学意义,P〈0．05;脑梗塞组中低密度脂蛋白（LDL）和同型半胱氨酸（Hcy）水平较TIA组高,差异有统计学意义,P〈0．05。结论对初次发生TIA的患者,护士应针对病人的具体情况,采取重点环节,各个击破的方法进行有效的健康教育,协助其戒烟戒酒,控制饮食,积极降低LDL和Hcy水平,从而减少不良预后的发生。     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

HPLC法测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱

目的 采用高效液相色谱（HPLC）法同时测定抗妇炎胶囊中木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱10种活性成分。方法 采用InerSustain AQ-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,流动相A：乙腈–无水乙醇（80∶20）,流动相B：0.1%磷酸溶液,梯度洗脱,检测波长220 nm,体积流量1.0 mL/min,柱温30℃,进样量10 μL。结果 木兰花碱、黄柏碱、药根碱、巴马汀、小檗碱、槐果碱、苦参碱、氧化槐果碱、槐定碱和氧化苦参碱分别在2.69～134.50、1.95～97.50、0.63～31.50、0.86～43.00、11.95～597.50、0.59～29.50、6.08～304.00、4.85～242.50、1.66～83.00、19.79～989.50 μg/mL线性关系良好（r≥0.999 3）;平均回收率分别为99.11%、98.23%、96.95%、97.78%、100.02%、97.21%、99.66%、99.52%、98.81%、100.08%,RSD值分别为1.04%、1.23%、1.37%、1.65%、0.70%、1.28%、0.65%、0.81%、1.11%、0.63%。结论 建立的HPLC法可用于抗妇炎胶囊中10种活性成分的测定,作为抗妇炎胶囊质量控制方法。     

Arformoterol: (R,R)-eformoterol, (R,R)-formoterol, arformoterol tartrate, eformoterol-sepracor, formoterol-sepracor, R,R-eformoterol, R,R-formoterol

Sepracor in the US is developing arformoterol [R,R-formoterol], a single isomer form of the beta(2)-adrenoceptor agonist formoterol [eformoterol]. This isomer contains two chiral centres and is being developed as an inhaled preparation for the treatment of respiratory disorders. Sepracor believes that arformoterol has the potential to be a once-daily therapy with a rapid onset of action and a duration of effect exceeding 12 hours. In 1995, Sepracor acquired New England Pharmaceuticals, a manufacturer of metered-dose and dry powder inhalers, for the purpose of preparing formulations of levosalbutamol and arformoterol. Phase II dose-ranging clinical studies of arformoterol as a longer-acting, complementary bronchodilator were completed successfully in the fourth quarter of 2000. Phase III trials of arformoterol began in September 2001. The indications for the drug appeared to be asthma and chronic obstructive pulmonary disease (COPD). However, an update of the pharmaceutical product information on the Sepracor website in September 2003 listed COPD maintenance therapy as the only indication for arformoterol. In October 2002, Sepracor stated that two pivotal phase III studies were ongoing in 1600 patients. Sepracor estimates that its NDA submission for arformoterol, which is projected for the first half of 2004, will include approximately 3000 adult subjects. Sepracor stated in July 2003 that it had completed more than 100 preclinical studies and initiated or completed 15 clinical studies for arformoterol inhalation solution for the treatment of bronchospasm in patients with COPD. In addition, Sepracor stated that the two pivotal phase III studies in 1600 patients were still progressing. In 1995, European patents were granted to Sepracor for the use of arformoterol in the treatment of asthma, and the US patent application was pending.     

欧洲刺柏（Juniper）

活性成分与药理作用欧洲刺柏药用部位是其浆果，具有促水排泄、防腐、抗胃肠胀气和抗风湿作用，还可改善胃功能。用作促水排泄药可增加尿量（水丢失），但不增加钠排泄。成分萜品烯-4-醇可增加肾小球滤过率，但刺激肾。欧洲刺柏浆果对单纯疱疹病毒体外显示抗病毒活性，并具抗真菌活性。动物实验显示，欧洲刺柏浆果提取物具有堕胎、抗生育、抗炎、抗胚胎植入、降血压、升血压和降血糖作用。欧洲刺柏浆果油具有兴奋子宫的活性，以及利尿、胃肠道抗菌和刺激作用，该油对平滑肌有阻止解痉作用。     

Oral Presentations (LDD, LPES, LNM, LPAT, LNT, LPPT, LPM)

Probiotic microorganisms have been shown to provide specific health benefits when consumed as food supplements or as food components. The main problem of such products is the poor survival of the probiotic bacteria in the low pH of gastric fluid. However the use of synthetic excipients for enteric coating to prevent the exposure of microorganisms to gastric fluid is limited in food supplementary industry. Therefore the aim of this study was to develop an enteric coating formulation containing shellac as a natural polymer. Shellac possesses good resistance to gastric juice; the major disadvantage of this polymer is its low solubility in the intestinal fluid [1, 2]. Thus films containing different ratios of shellac and water-soluble polymers (sodium alginate, hydroxypropyl methylcellulose (HPMC) and polyvinylpyrrolidon (PVP)) or plasticizers (glycerol and glyceryl triacetate (GTA)) were prepared in order to analyse the films’ melting temperatures (T_m), the changes in enthalpy (ΔH), their capability of taking up water, and their solubility in different media. The release characteristics of the films were studied by loading pellets with Enterococcus faecium M74 and coating them with formulations containing different amounts of shellac and polymer or plasticized shellac. Using dissolution tests, performed according to USP XXXI paddle method, the resistance of the coatings to simulated gastric fluid (SGF, pH 1.2) and the release of cells in simulated intestinal fluid (SIF, pH 6.8) was investigated.The trials showed that an increasing amount of plasticizer results in a decrease of T_m and ΔH of the films whereat glycerol had a superior plasticization effect to GTA. The compatibility of films made of water-soluble polymers and shellac was also concentration dependent. HPMC and PVP showed superior compatibility with shellac compared to sodium alginate, since films containing shellac and more than 10% [w/w] sodium alginate tended to separate into two phases. In the end five formulations containing shellac and either 5% [w/w] glycerol, 10% [w/w] PVP, 20% [w/w] PVP, 10% [w/w] HPMC, or 5% [w/w] sodium alginate emerged as feasible for enteric coating purposes.